Metatarsalgia encompasses an array of pathologies that cause pain to the forefoot. Having an accurate diagnosis is essential for effective treatment.
A complete history and examination are necessary to diagnose and treat lesser metatarsalgia properly. Carefully considering the biomechanical factors contributing to this painful foot condition may offer insights that will improve outcomes without complications.
What Is Metatarsalgia?
Metatarsalgia is pain and stiffness in the ball of your foot. It occurs when there is increased pressure on one or more long bones in the middle of your foot (metatarsals). These bones connect your ankle bones to your toes. The balls of your feet do a lot of work when you walk, run, and jump. Too much stress can lead to pain and other problems in the ball of your foot, such as a hard growth called a callus. Metatarsalgia in vets is a condition causing pain in the ball of the foot. It’s a common injury among service members who complete demanding jobs and training, putting much pressure on their feet.
Various conditions and habits can cause foot problems in the balls of your feet, such as wearing ill-fitting shoes or participating in high-impact activities. These activities place extra stress on the ball of your foot and can increase your risk of injury to your metatarsals. Common causes of ball of foot pain include flat feet, high arches, hammertoes, Morton’s neuroma, and arthritis. Symptoms of the ball of foot pain typically develop gradually over time. They can be sharp, shooting pain or persistent aching that worsens when standing, walking, or flexing your foot.
Symptoms
Symptoms include a painful feeling in the ball of your foot. It usually feels like a deep bruise but can also feel achy or burning. Pain can be exacerbated by weight-bearing activities such as standing or walking. It is typically worse if you wear ill-fitting shoes or exceptionally high heels, which shift more pressure onto the front of your feet. Foot deformities such as a high arch, a second toe longer than your big toe, and downward-curling toes (hammertoe) can also increase the likelihood of developing metatarsalgia.
You should see a doctor if you have pain in the ball of your foot that doesn’t go away after resting and changing your footwear. Nonsteroidal anti-inflammatory drugs or a podiatrist can help ease symptoms and relieve the pressure on the bones in your foot. Surgery may sometimes be necessary to reshape your foot bones and release irritated nerves. For many patients, however, conservative treatments are enough to alleviate symptoms.
Diagnosis
To diagnose metatarsalgia, a doctor will perform a physical examination and inquire about your symptoms. They will also examine the ball of your foot to see if it is red and hot and if you have swelling or pain with weight-bearing activities. X-rays or an MRI may be needed to confirm the diagnosis.
Participating in high-impact sports, such as running and jumping, can increase the risk of developing this condition due to added stress on the metatarsal area of the foot. People who wear shoes that do not fit well can also develop this problem. The tightness of the shoes can squeeze the foot and the bones in the ball of the foot. High heels or flat shoes without adequate padding and arch support can also increase pressure on the ball of the foot.
Other factors that can cause this foot problem include having a second toe longer than the big toe, bunions or calluses on the bottom of your feet, and being overweight. Regular icing of the feet can help relieve this pain.
Treatment
Several conditions can cause ball of foot pain, and it’s often difficult to know which one is causing the symptoms. Your doctor will conduct a thorough medical history and physical exam to determine the source of your pain. Imaging tests, including X-rays, ultrasounds, and MRIs, can help pinpoint areas of inflammation or other underlying problems such as bone spurs.
Treatment for metatarsalgia includes activity modification, shoe inserts, icing the feet, and physiotherapy. Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) can also reduce pain and swelling.
Symptoms are most common in physically active people, especially those participating in high-impact activities like running and dancing. Other risk factors for this type of pain include wearing ill-fitting shoes, being overweight, having diabetes, and having certain foot conditions. These conditions can increase pressure on the foot and toe bones. This can cause irritated nerves to send pain signals to the brain.
